Mobile Flexible Endoscopic Evaluation of Swallowing (mFEES) in Adults in Residential Aged Care Homes (RACHs): a feasibility study

Not Applicable

Completed

• Conditions: Dysphagia; Diet and Nutrition - Other diet and nutrition disorders; Oral and Gastrointestinal - Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon

• Registration Number: ACTRN12622001369718
• Lead Sponsor: The University of Melbourne

Brief Summary

Healthcare professionals and medical decision makers reported that mFEES facilitated a better understanding of residents’ swallowing function/dysphagia management and was beneficial over off-site services. Self-rated discomfort during mFEES was low and most residents presented with no or minimal anxiety about the procedure. Costs of mobile assessments are documented.

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Completion: 2021-10-29
• Study Start: 2022-10-25
• Last Update Posted: 31 October 2022

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 12

Inclusion Criteria

Inclusion criteria for residents:
- 18 years or older
- Resident identified with potential to benefit from FEES by their treating speech pathologist
- Approved for FEES by their treating general practitioner or geriatrician

Inclusion criteria for participating RACHs:
- the speech pathology service servicing the RACH expresses verbal agreement to support the FEES study
- the RACHs is able to give the research speech pathologist access to medical records of consenting participants to collect basic demographic information about the participants, information about their swallow and any factors that may influence the adult’s capacity to provide informed consent
- the RACH can provide a quite, clean, private area greater than 2 by 2 meters in size, with a sink and an emergency call button, where the mobile FEES procedure can be performed (including nasendoscope preparation, cleaning and participant assessment)
- the RACH is able to allow a division one (or above) nursing staff member (eg. clinical care manager) to:

a)inform the researcher if the participant has allergies, intolerances or medical conditions that could be compromised through the provision of inappropriate oral intake (e.g., adult requires a diabetic, gluten free or a low sodium diet, adult is on a strict fluid restriction)

b)be present throughout the mobile FEES procedure (approximately 15 minutes) and if necessary, provide the participant with food and drinks, as prepared and instructed by the research speech pathologist

-the RACH can provide some of the following items, if requested by the student researcher:
plastic examination gloves; 4 x teaspoons; 1 x tablespoon; 1 x fork; 4 x glasses of cordial (200m each); 1 x plate; 1 cup of tea/ coffee (on request); 1 dry cracker or biscuit; 1 slice of bread with butter; 1 banana; canned diced fruit (eg. peach or apricot); 1 tub of yogurt

- provide food/ fluids for assessment in addition to materials specified above in the following circumstances: it is medically indicated due to the participant’s intolerance(s)/ allergy(ies) or medical condition(s); the student researcher believes that it is appropriate to trial foods/fluids that are familiar and/or problematic for the participant; the participant expresses a preference for familiar food/ fluids

c)allow the student researcher timely and unobstructed access to the participant’s medical file so that she can screen the file for any contraindications to assessment on the day of the assessment

Exclusion Criteria

Exclusion criteria for residents:
- unstable cardiac condition
- unstable neurological condition e.g., in the
- process of a suspected stroke
- moderate-to-severe behavioural agitation,
- distress or aggression
- oxygen requirements exceed levels provided
- through nasal prongs ( > 5L/ min)
- severe movement disorder with hyperkinetic movements
- history or risk of severe epistaxis
- history of recurrent vasovagal episodes
- recent facial fractures or surgery
- known severe hypersensitivity of the nose and/ or nasopharynx and/ or oropharynx
- active infectious disease/ condition requiring - physical isolation from other residents
- bilateral nasal obstruction
- base of skull fracture
- identified by the treating speech pathologist as not having an adequate understanding of English, due to non-English speaking background, to consider the plain language statement and to make an informed decision about study participation
- medically ‘highly vulnerable’ as indicated by the treating GP/ Geriatrician in discussion with the research speech pathologist*

Study & Design

• Study Type: Interventional
• Study Design: Not specified